<b>Radiation Injury After Hypofractionated Stereotactic Radiotherapy for Peripheral Small Lung Tumors:</b> Serial Changes on CT

Takeda, Toshiaki; Takeda, Atsuya; Kunieda, Etsuo; Ishizaka, Akitoshi; Takemasa, Kazuhiko; Shimada, Kaoru; Yamamoto, Seiichiro; Shigematsu, Naoyuki; Kawaguchi, Osamu; Fukada, Junichi; Ohashi, Toshio; Kuribayashi, Sachio; Kubo, Atsushi

doi:10.2214/ajr.182.5.1821123

Cited by 85 publications

(63 citation statements)

References 14 publications

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“…Aoki et al 15 reported patchy consolidation or discrete consolidation in 74% of cases during the fi rst 6 months after SBRT. Takeda et al 16 reported that dense consolidation was observed in 73% of cases. Assuming that these manifestations on CT correspond to our "mass-like consolidation", our results, that mass-like consolidation appeared in 68% of tumors treated with SBRT, are in accordance with these previous results.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of mass-like consolidation after stereotactic body radiation therapy for lung tumors

et al. 2007

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Section: Discussionmentioning

confidence: 97%

Evaluation of mass-like consolidation after stereotactic body radiation therapy for lung tumors

et al. 2007

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“…In one report that examined serial changes on a CT scan after SBRT, a local consolidation was detected in 73% of irradiated lesions, and for six of the cases (38%), movement of the opacity was observed: consolidations disappeared in previously affected lung areas and appeared in new areas. 17 The authors interpreted these findings as fibrosis. Radiological findings within the IF are difficult to interpret and the priority is to differentiate radiation-induced opacities from a recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy with helical TomoTherapy for medically inoperable early stage primary and second-primary non-small-cell lung neoplasm: 1-year outcome and toxicity analysis

Casutt

Bouchaab²,

Bourhis³

et al. 2015

BJR

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The authors Alban Lovis and Oscar Matzinger contributed equally to this article.Objective: This study investigated the effectiveness of stereotactic body radiotherapy with helical TomoTherapy (T-SBRT) for treating medically inoperable primary and second-primary early stage non-small-cell lung neoplasm (SPLN) and evaluated whether the movement of organizing pneumonia (OP) within the irradiation field (IF) can be detected via analysis of radiological changes. Methods: Patients (n 5 16) treated for 1 year (2011-12) at our hospital by T-SBRT at a total dose of 60 Gy in five fractions were examined retrospectively. Outcome and toxicity were recorded and were separately described for SPLN. CT scans were reviewed by a single radiologist. Results: Of the 16 patients, 5 (31.3%) had primary lung malignancies, 10 (62.5%) had SPLN, and 1 case (6.3%) had isolated mediastinal metastasis of lung neoplasm. Pathological evidence was obtained for 72.2% of all lesions. The median radiological follow-up was 11 months (10.5 months for SPLN). For all cases, the 6-and 12-month survival rates were 100% and 77.7% (100% and 71.4%, respectively, for SPLN), and the 6-and 12-month locoregional control rates were 100% in all cases. 2 (12.5%) of 16 patients developed grade 3 late transient radiation pneumonitis following steroid therapy and 1 (6.3%) presented asymptomatic infiltrates comparable to OP opacities. Conclusion: T-SBRT seems to be safe and effective. Advances in knowledge: Mild OP is likely associated with radiation-induced anomalies in the IF, identification of migrating opacities can help discern relapse of radiationinduced opacities.

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“…Data from a recent publication indicate that current RECIST criteria may have positive predictive value as low as 28%, leading to a high number of false positive results [10] . Incorporating additional anatomic and metabolic imaging data, although not 100% specific, may help to improve the diagnostic accuracy of recurrences [10][11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

Evaluating patterns of failure and salvage therapy for patients treated with primary stereotactic body radiation therapy for early stage non-small cell lung cancer

Mezera

Chandrasekhar

Kloecker

et al. 2014

JST

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Objective: The purpose of this study is to evaluate patterns of failure after stereotactic body radiation therapy for early stage NSCLC and determine the role of salvage therapy on patient outcome.Methods: Eighty-two consecutive medically inoperable patients treated with definitive SBRT for early-stage NSCLC were examined. Ninety-four percent of patients had biopsy proven disease, the remainder refused. The median biologic effective dose (BED) for the cohort was 100 Gy (range, 78-180 Gy). Recurrence was defined clinically by RECIST and FDG-PET or by pathologic diagnosis. Results:The estimated median survival for the entire cohort was 29.2 months (range, 1 -40.3). The estimated 2 year overall survival (OS) was 65%. The 2 year local recurrence free survival, locoregional recurrence free survival and distant metastatic free survival were 89%, 78% and 72%, respectively. Of those with locoregional failure, ten were treated with salvage SBRT at a median time of 10 months from prior SBRT. Six patients were treated with systemic chemotherapy and 2 patients were offered palliative care. All patients treated with salvage SBRT remained controlled at a median time of 12 months. Treatment was well tolerated with 2 patients experiencing grade 2 pneumonitis, 1 patient experiencing grade 3 chest wall pain and 1 with rib fracture. OS was compared between 3 subgroups: no locoregional failure (n = 65), locoregional failure without SBRT salvage (n = 7) and locoregional failure with SBRT salvage (n = 10). The estimated median survival 31.3 months, 14.3 months and 29.9 months, respectively (p = 0.007). Conclusion:In our single institution patient cohort, SBRT in the salvage setting for locoregional recurrences after initial definitive SBRT for early-stage NSCLC is a potential option. Additional prospective data is needed.

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Radiation Injury After Hypofractionated Stereotactic Radiotherapy for Peripheral Small Lung Tumors: Serial Changes on CT

Cited by 85 publications

References 14 publications

Evaluation of mass-like consolidation after stereotactic body radiation therapy for lung tumors

Evaluation of mass-like consolidation after stereotactic body radiation therapy for lung tumors

Stereotactic body radiotherapy with helical TomoTherapy for medically inoperable early stage primary and second-primary non-small-cell lung neoplasm: 1-year outcome and toxicity analysis

Evaluating patterns of failure and salvage therapy for patients treated with primary stereotactic body radiation therapy for early stage non-small cell lung cancer

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